Anxiety and anxious-depression in Parkinson's disease over a 4-year period: a latent transition analysis
Identifieur interne : 000044 ( Main/Exploration ); précédent : 000043; suivant : 000045Anxiety and anxious-depression in Parkinson's disease over a 4-year period: a latent transition analysis
Auteurs : S Landau [Royaume-Uni] ; V Harris [Royaume-Uni] ; D Burn [Royaume-Uni] ; J Hindle [Royaume-Uni] ; C Hurt [Royaume-Uni] ; M Samuel [Royaume-Uni] ; K Wilson [Royaume-Uni] ; R Brown [Royaume-Uni]Source :
- Psychological Medicine [ 0033-2917 ] ; 2015.
Abstract
Depression and anxiety in Parkinson's disease are common and frequently co-morbid, with significant impact on health outcome. Nevertheless, management is complex and often suboptimal. The existence of clinical subtypes would support stratified approaches in both research and treatment.
Five hundred and thirteen patients with Parkinson's disease were assessed annually for up to 4 years. Latent transition analysis (LTA) was used to identify classes that may conform to clinically meaningful subgroups, transitions between those classes over time, and baseline clinical and demographic features that predict common trajectories.
In total, 64.1% of the sample remained in the study at year 4. LTA identified four classes, a ‘Psychologically healthy’ class (approximately 50%), and three classes associated with psychological distress: one with moderate anxiety alone (approximately 20%), and two with moderate levels of depression plus moderate or severe anxiety. Class membership tended to be stable across years, with only about 15% of individuals transitioning between the healthy class and one of the distress classes. Stable distress was predicted by higher baseline depression and psychiatric history and younger age of onset of Parkinson's disease. Those with younger age of onset were also more likely to become distressed over the course of the study.
Psychopathology was characterized by relatively stable anxiety or anxious-depression over the 4-year period. Anxiety, with or without depression, appears to be the prominent psychopathological phenotype in Parkinson's disease suggesting a pressing need to understanding its mechanisms and improve management.
Url:
DOI: 10.1017/S0033291715002196
PubMed: 26492977
PubMed Central: 4697304
Affiliations:
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<front><div type="abstract" xml:lang="en"><sec id="sec_a1"><title>Background</title>
<p>Depression and anxiety in Parkinson's disease are common and frequently co-morbid, with
significant impact on health outcome. Nevertheless, management is complex and often
suboptimal. The existence of clinical subtypes would support stratified approaches in
both research and treatment.</p>
</sec>
<sec id="sec_a2" sec-type="methods"><title>Method</title>
<p>Five hundred and thirteen patients with Parkinson's disease were assessed annually for
up to 4 years. Latent transition analysis (LTA) was used to identify classes that may
conform to clinically meaningful subgroups, transitions between those classes over time,
and baseline clinical and demographic features that predict common trajectories.</p>
</sec>
<sec id="sec_a3" sec-type="results"><title>Results</title>
<p>In total, 64.1% of the sample remained in the study at year 4. LTA identified four
classes, a ‘Psychologically healthy’ class (approximately 50%), and three classes
associated with psychological distress: one with moderate anxiety alone (approximately
20%), and two with moderate levels of depression plus moderate or severe anxiety. Class
membership tended to be stable across years, with only about 15% of individuals
transitioning between the healthy class and one of the distress classes. Stable distress
was predicted by higher baseline depression and psychiatric history and younger age of
onset of Parkinson's disease. Those with younger age of onset were also more likely to
become distressed over the course of the study.</p>
</sec>
<sec id="sec_a4" sec-type="conclusion"><title>Conclusions</title>
<p>Psychopathology was characterized by relatively stable anxiety or anxious-depression
over the 4-year period. Anxiety, with or without depression, appears to be the prominent
psychopathological phenotype in Parkinson's disease suggesting a pressing need to
understanding its mechanisms and improve management.</p>
</sec>
</div>
</front>
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